Genotypes and antimicrobial resistant phenotypes of Neisseria gonorrhoeae in Portugal (2004-2009)

Carlos Florindo (1) , Rui Pereira (1) , Márcia Boura (1) , Baltazar Nunes (1) , Albertina Paulino (1) , João Gomes (1) , Maria Borrego (1)

1 National Institute of Health

Objectives: To determine the antibiotic phenotype and genotype distribution of N. gonorrhoeae isolates in Portugal between 2004 and 2009, and to evaluate specific associations between genotypes and sexual orientation, age, and antibiotic resistance. Methods: A total of 236 N. gonorrhoeae isolates were typed through NG-MAST. The polymorphism degree and the phylogenetic relatedness among NG-MAST STs were evaluated by MEGA4 software on concatenated sequences of por and tbpb alleles. E-test was used to determine the susceptibility to ceftriaxone, ciprofloxacin, penicillin, and spectinomycin. Results: No isolates displayed resistance to spectinomycin and ceftriaxone whereas 79.1% and 37.4% were resistant to penicillin and ciprofloxacin, respectively. We found 104 different STs (1 ST per 2.3 isolates), where the most frequent were ST210 (8.1%) and ST225 (7.6%). STs formed two major groups separated by 159.8 [SE 8.9] nucleotide differences, yielding several subgroups, one of them including the worldwide prevalent ST225. The probability of ciprofloxacin resistance among isolates within this subgroup was 73.5-fold higher than for the remaining isolates. Indeed, for the genetically closest subgroup, which includes the most prevalent ST210, only 8.0% of isolates were resistance to ciprofloxacin. There was a non-homogeneous distribution per year for ST225 (p<0.001), ST210 (p=0.011), and ST2 (p=0.007). Conclusions: The heterogeneous STs scenario may represent the “tip of the iceberg”, reflecting a high number of undiagnosed and not reported gonorrhoea cases. A laboratory-based national surveillance of N. gonorrhoeae infections is mandatory to provide a broader spectrum of isolates that will allow the establishment of the scenario of the Portuguese sexual networks.

Mots clés: ANTIBIOTIC RESISTANCE; MOLECULAR TYPING; NEISSERIA GONORRHOEAE

Carlos Florindo, Rui Pereira, Márcia Boura, Baltazar Nunes, Albertina Paulino, et al.. Genotypes and antimicrobial resistant phenotypes of Neisseria gonorrhoeae in Portugal (2004-2009). Sexually Transmitted Infections, 2010, 86 (6), pp.449. ⟨10.1136/sti.2010.044321⟩. ⟨hal-00576095⟩